The Department of General Practice is conducting several projects to explore the relationship between Covid-19 and cardiovascular disease: COVID@HEARTconsortium.
Inflammation and thrombosis
Over the last months, the world is experiencing a global outbreak of Covid-19. Covid-19 is a viral respiratory infection in most patients, but in about 10% deterioration into critical illness with a high mortality rate may occur. The development of critical illness appears to be linked with age and male sex, but also with cardiovascular disease, exemplified by the overrepresentation of cardiovascular disease and risk factors (diabetes, obesity) in hospitalized patients. The causal pathway of deterioration into critical illness likely is linked to vessel wall inflammation, vascular leakage and formation of blood clots that can obstruct blood flow in the lungs.
The members of the COVID@HEART consortium strongly believe that mitigating this cardiovascular burden of Covid-19 should start early, when patients are (still) at home, not yet hospitalized.
Enhancing and catalyzing outpatient care
The goals of this consortium are threefold. First, we will develop a tool that helps to identify (cardiovascular) high-risk patients with Covid-19 in the first days of infection, when at home, before critical illness has emerged. General practitioners can use this tool to ‘flag’ high-risk patients, monitor them more closely, e.g. home saturation measurements, and refer timely to the hospital. Even cooperative care with hospital specialist could be an option.
Second, we will develop a diagnostic tool that allows for an improved, early distinction between Covid-19 and acute myocardial infarction. This because it is for general practitioners sometimes difficult to distinguish both diseases due to overlapping symptomatology.
Finally, Covid-19 may be ‘a cardiovascular stress test’ and thus result in acceleration of the development of cardiovascular disease. With an ‘early diagnosis strategy’ including a questionnaire and cardiac biomarker blood testing we aim to detect early stages of cardiovascular disease in Covid-19 survivors.
The COVID@HEART consortium receives funding from the Dutch Heart Foundation.
The consortium is co-led by prof. dr. Frans Rutten, professor of general practice and dr. Geert-Jan Geersing, associate professor of general practice.
Consortium partners include dr. Maryam Kavousi, associate professor at the Department of Epidemiology from the Erasmus University Rotterdam (ERGO study), dr. Thijs Eijsvogels, associate professor at the Department of Physiology from the Radboud University Nijmegen.
Furthermore, participating colleagues from the Julius Center are dr. Dorien Zwart (associate professor), dr. Roderick Venekamp (associate professor), dr. Sander van Doorn (assistant professor), dr. Maarten van Smeden (assistant professor), dr. Toshi Takada (assistant professor), drs. Florien van Royen (PhD student), and drs. Linda Joosten (PhD student).
Finally, from the Department of Pharmaco-Epidemiology at Utrecht University participating colleagues are prof. dr. Olaf Klungel and dr. Patrick Soeverein.